PDF(Pubmed)
Abstract：
Chronic hepatitis C virus (HCV) infection is characterized by a variety of extra-hepatic manifestations; peripheral neuropathy (PN) is one of the most common, especially when mixed cryoglobulinemia (MCG) is present. The prevalence and risk factors of HCV-related PN in the absence of MCG are largely unknown. We conducted a prospective, single-center study, examining the prevalence and reversibility of HCV-associated neuropathy in the absence of MCG. Nerve fiber density in the epidermis was evaluated through skin biopsy and electroneurography (ENG) before HCV-treatment initiation and 1 year post sustained virological remission (SVR). Forty HCV-infected individuals (nine HIV co-infected) with no other neuron-harming factors were included; four other HCV mono- and three HIV co-infected individuals were excluded due to presence of diabetes, B12 insufficiency, or neurotoxic drugs. Twelve consecutive controls with no neuron-harming conditions were also recruited; eight more were excluded due to meeting exclusion criteria. Four patients had ENG signs of polyneuropathy (two with HCV mono- and two with HIV co-infection), while seven more (five with HCV mono- and two with HIV co-infection) had signs of mono-neuropathy, leading to PN prevalences of 22.5% and 44% for mono- and co-infection, respectively (p value 0.179). The two patients with HCV mono-infection and polyneuropathy and the one with ulnar nerve damage showed ENG improvement 1 year post SVR. Regarding intraepidermal nerve density, HCV infection, irrespective of HIV co-infection, was correlated with a lower intraepidermal neuron density that improved 1 year post SVR (p value 0.0002 for HCV and 0.0326 for HCV/HIV co-infected patients). PN is common in HCV infection; successful eradication of HCV leads to PN improvement.
摘要：
慢性丙型肝炎病毒(HCV)感染的特点是各种肝外表现,周围神经病变(PN)是最常见的,特别是当混合性冷球蛋白血症（MCG）存在。在缺乏MCG的情况下，HCV相关PN的患病率和危险因素在很大程度上是未知的。我们进行了一个前瞻性的，单中心研究,在没有MCG的情况下检查HCV相关神经病的患病率和可逆性。在HCV治疗开始之前和持续病毒学缓解（SVR）后1年，通过皮肤活检和神经电图（ENG）评估表皮中的神经纤维密度。包括40名HCV感染者（9名HIV共感染），没有其他神经元伤害因素；由于存在糖尿病，其他4名HCV单感染和3名HIV共感染个体被排除在外。B12不足，或神经毒性药物。还招募了12个没有神经元损伤条件的连续对照；由于符合排除标准，另外8个被排除在外。4例患者有多发性神经病的ENG征象（2例HCV单发和2例HIV合并感染），而另外7例（5例HCV单感染和2例HIV共感染）有单一神经病变的迹象，导致单感染和共感染的PN患病率为22.5%和44%，分别(p值0.179)。两名患有HCV单一感染和多发性神经病的患者和一名患有尺神经损伤的患者在SVR后1年表现出ENG改善。关于表皮内神经密度，HCV感染,不管艾滋病毒共同感染，与SVR后1年改善的较低表皮内神经元密度相关(HCV的p值0.0002和HCV/HIV共感染患者的p值0.0326)。PN在HCV感染中很常见;成功根除HCV导致PN改善。
